| NPI | 1770716854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 021252) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 004220) |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2020-05-14 |